Healthcare Provider Details

I. General information

NPI: 1437067691
Provider Name (Legal Business Name): ANTERO PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 NOTT HWY UNIT 5
ASHFORD CT
06278-1341
US

IV. Provider business mailing address

39 NOTT HWY UNIT 5
ASHFORD CT
06278-1341
US

V. Phone/Fax

Practice location:
  • Phone: 860-477-0523
  • Fax: 860-477-0595
Mailing address:
  • Phone: 860-477-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAWN SOPELAK
Title or Position: OFFICE MANAGER
Credential:
Phone: 860-477-0523